Abstract

Because of population ageing, fall prevention represents a human, economic, and social issue. Currently, fall-risk is assessed infrequently, and usually only after the first fall occurrence. Home monitoring could improve fall prevention. Our aim was to monitor daily activities at home in order to identify the behavioral parameters that best discriminate high fall risk from low fall risk individuals. Microsoft Kinect sensors were placed in the room of 30 patients temporarily residing in a rehabilitation center. The sensors captured the patients’ movements while they were going about their daily activities. Different behavioral parameters, such as speed to sit down, gait speed or total sitting time were extracted and analyzed combining statistical and machine learning algorithms. Our algorithms classified the patients according to their estimated fall risk. The automatic fall risk assessment performed by the algorithms was then benchmarked against fall risk assessments performed by clinicians using the Tinetti test and the Timed Up and Go test. Step length, sit-stand transition and total sitting time were the most discriminant parameters to classify patients according to their fall risk. Coupling step length to the speed required to stand up or the total sitting time gave rise to an error-less classification of the patients, i.e., to the same classification as that of the clinicians. A monitoring system extracting step length and sit-stand transitions at home could complement the clinicians’ assessment toolkit and improve fall prevention.

Highlights

  • As we age, our functional abilities tend to decline

  • We used an ambient sensor to monitor for a whole day the daily activities of thirty patients residing in a rehabilitation center

  • When two parameters were used for the classification, some parameters combinations gave rise to a 100% mean accuracy, i.e., a classification 100% identical to that of the clinicians

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Summary

Introduction

Any combination thereof, can underlie this decline, such as sensorimotor deficits associated with the aging of our sensory systems (e.g., proprioceptive, vestibular, and/or visual systems), strength loss, or cognitive impairment, to name a few. This functional decline is notably characterized by an impaired control of balance, an altered gait pattern, reduced mobility, and falls. According to the World Health Organization, “28–35% of people aged 65 and over fall each year, increasing to 32–42% for those over 70 years of age” [1]. Fall frequency increases with age and frailty level [2], usually from the age 65 on

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